Anxiety disorders and effective treatment

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Everyone feels anxious from time to time. Stressful situations such as meeting tight deadlines or important social obligations often make us nervous or fearful. Experiencing mild anxiety may help a person become more alert and focused on facing challenging or threatening circumstances.

But individuals who experience extreme fear and worry that does not subside may be suffering from an anxiety disorder. The frequency and intensity of anxiety can be overwhelming and interfere with daily functioning. Fortunately, the majority of people with an anxiety disorder improve considerably by getting effective psychological treatment.

What are the major kinds of anxiety disorders?

There are several major types of anxiety disorders, each with its own characteristics.

People with generalized anxiety disorder have recurring fears or worries, such as about health or finances, and they often have a persistent sense that something bad is just about to happen. The reason for the intense feelings of anxiety may be difficult to identify. But the fears and worries are very real and often keep individuals from concentrating on daily tasks.

Panic disorder involves sudden, intense and unprovoked feelings of terror and dread. People who suffer from this disorder generally develop strong fears about when and where their next panic attack will occur, and they often restrict their activities as a result.

A related disorder involves phobias, or intense fears, about certain objects or situations. Specific phobias may involve things such as encountering certain animals or flying in airplanes, while social phobias involve fear of social settings or public places.

Obsessive-compulsive disorder is characterized by persistent, uncontrollable and unwanted feelings or thoughts (obsessions) and routines or rituals (compulsions) in which individuals engage to try to prevent or rid themselves of these thoughts. Examples of common compulsions include washing hands or cleaning house excessively for fear of germs, or checking work repeatedly for errors.

Someone who suffers severe physical or emotional trauma such as from a natural disaster or serious accident or crime may experience post-traumatic stress disorder. Thoughts, feelings and behavior patterns become seriously affected by reminders of the event, sometimes months or even years after the traumatic experience.

Symptoms such as extreme fear, shortness of breath, racing heartbeat, insomnia, nausea, trembling and dizziness are common in these anxiety disorders. Although they may begin at any time, anxiety disorders often surface in adolescence or early adulthood. There is some evidence that anxiety disorders run in families; genes as well as early learning experiences within families seem to make some people more likely than others to experience these disorders.

Why is it important to seek treatment for these disorders?

If left untreated, anxiety disorders can have severe consequences. For example, some people who suffer from recurring panic attacks avoid any situation that they fear may trigger an attack. Such avoidance behavior may create problems by conflicting with job requirements, family obligations or other basic activities of daily living.

People who suffer from an untreated anxiety disorder often also suffer from other psychological disorders, such as depression, and they have a greater tendency to abuse alcohol and other drugs. Their relationships with family members, friends and coworkers may become very strained. And their job performance may decline.

Are there effective treatments available for anxiety disorders?

Absolutely. Most cases of anxiety disorder can be treated successfully by appropriately trained mental health professionals such as licensed psychologists. Research has demonstrated that a form of psychotherapy known as "cognitive-behavioral therapy" (CBT) can be highly effective in treating anxiety disorders. Psychologists use CBT to help people identify and learn to manage the factors that contribute to their anxiety.

Behavioral therapy involves using techniques to reduce or stop the undesired behaviors associated with these disorders. For example, one approach involves training patients in relaxation and deep breathing techniques to counteract the agitation and rapid, shallow breathing that accompany certain anxiety disorders.

Through cognitive therapy, patients learn to understand how their thoughts contribute to the symptoms of anxiety disorders, and how to change those thought patterns to reduce the likelihood of occurrence and the intensity of reaction. The patient's increased cognitive awareness is often combined with behavioral techniques to help the individual gradually confront and tolerate fearful situations in a controlled, safe environment.

Along with psychotherapy, appropriate medications may have a role in treatment. In cases where medications are used, the patient's care may be managed collaboratively by more than one provider of treatment. It is important for patients to realize that there are side effects to any drugs, which must be monitored closely by the provider who prescribed the medication.

How can licensed psychologists help someone suffering from an anxiety disorder?

Licensed psychologists are highly trained and qualified to diagnose and treat people with anxiety disorders using techniques based on best available research. Psychologists' extensive training includes understanding and using a variety of psychotherapies, including CBT.

Psychologists sometimes use other approaches to effective treatment in addition to individual psychotherapy. Group psychotherapy, typically involving unrelated individuals who all have anxiety disorders, can be an effective approach to delivering treatment and providing support. Further, family psychotherapy can help family members better understand their loved one's anxiety and learn new ways of interacting that do not reinforce the anxiety and associated dysfunctional behaviors.

Individuals suffering from anxiety disorders may also want to consider mental health clinics or other specialized treatment programs dealing with specific anxiety disorders such as panic or phobias that may be available in their local area.

How long does psychological treatment take?

The large majority of people who suffer from an anxiety disorder are able to reduce or eliminate their anxiety symptoms and return to normal functioning after several months of appropriate psychotherapy. Indeed, many people notice improvement in symptoms and functioning within a few treatment sessions. The patient should be comfortable from the outset with the psychotherapist. Together the patient and psychotherapist should develop an appropriate treatment plan. The patient's cooperation is crucial, and there must be a strong sense that the patient and therapist are collaborating well as a team to treat the anxiety disorder.

No one plan works well for all patients. Treatment needs to be tailored to the needs of the patient and to the type of disorder, or disorders, from which the individual suffers. The psychotherapist and patient should work together to assess whether a treatment plan seems to be on track. Patients respond differently to treatment, and adjustments to the plan sometimes are necessary. Anxiety disorders can severely impair a person's functioning in work, family and social environments. But the prospects for long-term recovery are good for most individuals who seek appropriate professional treatment. People who suffer from anxiety disorders can work with a qualified and experienced mental health professional such as a licensed psychologist to help them regain control of their feelings and thoughts — and their lives.

Updated June 2010

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